Amadoda amaningi anesifo senhliziyo angathatha isilfayili ngokuphepha
I-Viagra (i-sildenafil) iguqule ukwelashwa kwesifo sobulili besilisa. Kodwa-ke, ukusetshenziswa kwayo kuthiwa kuyingozi ezigulini ezinezinhlobo ezithile zesifo senhliziyo. Inhloso yalesi sihloko ukubuyekezwa ukusetshenziswa okuphephile kwe-sildenafil emadodeni anesifo senhliziyo.
Imiphumela emibi yokuthatha i-Sildenafil enezinhliziyo zenhliziyo
I-Sildenafil inezinyathelo ezimbili ezingase zibe yiphutha kwiziguli ezinesifo senhliziyo.
Okokuqala, kunganciphisa ukucindezelwa kwegazi. Okwesibili, ihlangana ne-nitrate.
I-Sildenafil iyi-vasodilator (okungukuthi, isidakamizwa esithwala imithwalo yegazi ), futhi ngenxa yalokho, sinciphisa umfutho wegazi we- systolic (inombolo "phezulu" e-blood pressure measurements) nge-8 mmHg. Eziningi zeziguli ezinesifo senhliziyo, kufaka phakathi iningi lalabo abaphathwa ngezidakamizwa ezinamandla, lokhu akuyona inkinga. Ucwaningo luye lwabonisa ukuthi isifo semiphumela emibi (kuhlanganise nemiphumela emibi ehlobene nomfutho wegazi ophansi, njengokuzondeka nokuphelelwa amandla) akuyona into ephakeme kubasebenzisi be-sildenafil abathwala izidakamizwa ezinamandla.
Kodwa-ke, imiphumela ye-vasodilating ye-sildenafil ingaba yingozi lapho ihlanganiswa nemiphumela ye-vasodidi ye-nitrate, izidakamizwa ezisasetshenziswa kakhulu kwiziguli ezine-artery disease. Iziguli ezithatha kokubili i-nitrate ne-sildenafil ziyakwazi ukuthuthukisa ukucindezeleka okukhulu ( ukucindezelwa kwegazi okuphansi ) kanye ne-syncope (ukuphelelwa amandla.) Iziguli ezithatha i-nitrate ngenxa yesifo se-coronary artery, ngakho-ke, akufanele neze ithathe isilfinifil.
Ngaphezu kwalokho, noma ubani othathe i-sildenafil phakathi namahora angu-24 adlule akufanele athathe i-nitrate.
Lapho i-sildenafil isungulwa kuqala ngasekupheleni kwawo-1990, imibiko yokuhlasela kwenhliziyo nokufa okungazelelwe ngemuva kokuthatha lesi sidakamizwa kwavela kuzo zonke izindaba. Ucwaningo oluqhubekayo luye lwasikisela ukuthi, kwiziguli ezingathathi i-nitrate , ukusebenzisa i-sildenafil ezigulini ezine-stonary artery disease akuyona imbangela yokwanda kwenhliziyo noma ukufa.
Ngesikhathi lezi zenzakalo zikhona ngempela ezigulini ezinezifo zethambo lomzimba , izifo zabo azikho ngaphezulu kweziguli ezithatha isilfayili.
Ngempela, i-sildenafil ibonakala ibekezeleleke kakhulu kubantu abanobuhlungu obukhulu be-artery coronary, uma nje bengenaso ischemia esebenzayo (izikhathi lapho imisipha yenhliziyo ingatholi ukugeleza kwegazi okufanele, okuvame ukuboniswa ubuhlungu besifuba ) futhi ayithathi i-nitrate. Ngaphezu kwalokho, i-sildenafil ayinakwandisa ingozi yokuzivocavoca ezigulini ezinesifo esiqinile esinesifo se-coronary artery.
Kukhona ezinye izimo lapho ukwehla okuphansi kwe-systolic blood pressure okubangelwa i-sildenafil kungaba yingozi. Iziguli ezinezinhliziyo ezinzima ukwehluleka okuhambisana ne-low blood pressure measurements zingaba zimbi nakakhulu uma kuqhubeka ukwenziwa kwe-hypotension. Ngaphezu kwalokho, ezinye iziguli ezine- hypertrophic cardiomyopathy zingase zibonakale uma isisindo segazi se-systolic sinciphile.
Okubalulekile
I-American College of Cardiology kanye ne-American Heart Association bayavuma ukuthi i-sildenafil iphephile kubantu abaphethe isifo somzimba we-coronary artery abangathathi i-nitrate kodwa akufanele basebenzise ngeziguli ezithatha i-nitrate. (I-Nitrate ihlanganisa zonke izinhlobo ze-nitroglycerin - ezilinganiselwe, ama-transdermal namafrayomu amafomu - kanye ne-isosorbide mononitrate, isosorbide dinitrate, i-pentaerythritol tetranitrate, i-erythritol tetranitrate, ne-amyl nitrate.)
Kumele kuqashelwe ukuthi, ngenkathi i-nitrate eyedlule kwakuyisisekelo sokwelashwa kwesifo se-coronary artery, lokhu akusasekho. Esikhathini se- angioplasty kanye nesifo se-stenting, isifo se-artery coronary ngokuvamile silawulwa ngaphandle kokusebenzisa i-nitrate. Iziguli ezibekwe i-nitrate futhi zifisa ukuthatha i-sildenafil kufanele zicele odokotela bakho ngezinye izindlela zokwelashwa ngenxa yesifo sabo se-coronary artery.
Kukhona amanye amaqembu ezinhliziyo ze-sildenafil okungenzeka kube yingozi. Lezi zihlanganisa iziguli ezine-artery coronary disease engazinzile noma isifo se-coronary isteria esebenzayo (okungukuthi, iziguli ezinesifo somugqa ongasebenzi). Lezi ziguli, ngokusobala, zinenkinga yezokwelapha esebenzayo okudingeka iqiniseke ukuthi ngabe i-sildenafil iyacutshungulwa noma cha.
Uma seziphathwa ngokwanele, ukusetshenziswa kwe-sildenafil (kanye nazo zonke ezinye izinhlobo zendlela yokuphila, impilo yansuku zonke njengokuzivocavoca) kungakhangwa.
Ezinye iziguli ezingase zibe nenkinga nge-sildenafil yilabo abanenkinga yezinhliziyo ezihambisana nomfutho wegazi ophansi we-borderline , ezinye iziguli ezine-hypertrophic cardiomyopathy, futhi mhlawumbe, iziguli ezithinta izidakamizwa ezinzima zomfutho wegazi ophakeme.
Ngaphandle kwalokhu, i-sildenafil ingasetshenziswa ngokuphepha kuningi lamagciwane anesifo senhliziyo.
Imithombo:
UKostis JB, uJackson G, uRenen R, et al. Ukukhubazeka ngokobulili kanye nengozi yomzimba (i-Second Princeton Consensus Conference). Am J Cardiol 2005; 96: 313.